Insurance Fraud | GTAMotorcycle.com

Insurance Fraud

Sort of. There are many pigs at the trough. Ambulance chasing lawyers and their lobby group. A whole rehab industry that caters to accident and injury fraud. Towing industry. Auto body shops. And there are regular fraudsters too.

Then there are the bad guys... a triad that includes Queens Park, FSCO and the insurance industry. They collaborate as a cartel because they all benefit from high rates.

As long as the public can pay, or until it becomes a real election issue there is no incentive to change.
 
The insurance industry has deep roots for sure with a very strong team of lobbyists. They will continue to release studies and documents and have articles placed in mainstream media discussing how they are getting screwed. Yeah fraud exists, it does everywhere. But what’s happening with insurance in this province goes against what’s happening in other regions, specifically the US. Fraud exists there too.

We have half the riding season as riders do in the southern states, which in theory would double the liability exposure to the insurers. We also must wear helmets, which aren’t required in some of those states. Think of the claims for severe head trauma, and the lawsuits that come along with those injuries. Yet insurers in the US are hungry for new motorcycle business and rates are ridiculously low and stable compared to what us suckers in Canada have to pay.

Mad Mike hit the nail on the head, This problem is larger than insurance, it’s a sociopolitical issue we as Canadians need to deal with. Our system is broken and the lowly citizen is left holding the bag.

Pay up Canada.
 
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Here's what's in it for each stakeholder:

Lawyers. Chasing ambulances is lucrative. Since these guys get paid a percentage of the settlement, it's in their best interest to drive up the costs throught medical referrals, rehab etc.

Rehab industry collaborates with ambulance chasers. They even have a lobby group, FAIR, disguised as a victims right's advocate. Read more at Corporate Members that Support FAIR - FAIR. Without lawyers, these folks claim victims would be at the mercy of OHIP. Instead they get a steady stream of lucrative referrals from Lawyers!

Towing, Tips for Avoiding Tow Truck and Storage Scams

Body Shops.

Insurance companies: Unlike any other industry, they are able to build fraud into their cost with impunity. They have no incentive fight fraud as long as the FSCO allows them include it as a cost of business.

Govt. Just think -- the gov't collects HST off ever fraud dollar billed. They also take OHIP compensation payouts from the insurance companies that are reentered as cost which again are passed along to consumers.
 
You know those legal firms that advertise they go after more for you? Some are owned by insurance companies.
 
Go look at your policy and see what costs what on it.

Looking at the renewal I just received for my Aprilia, I see a premium of $1293 for 19/20.

Of that:
- $51 is direct comp/property damage (3.9%)
- $239 is liability (18.5%)
- $144 is collision (11.1%)
- $54 is comprehensive (4.2%)

and

- $805 is statutory accident benefits (62.3%)

SABs constitute more than 62% of the cost of my premium. If the government hadn't mandated accident benefits I too could, in theory, be crowing about being able to ride covered only by direct-comp/prop and liability; in my case that would theoretically be $290 or twelve easy payments of $CAD24/mo for a 175HP, 1100cc hyper-naked.

You want to lower insurance costs? Lobby your local politician to make accident benefits optional and roll the dice by opting out. But you need to be ready to go it alone if something bad does happen.

I personally think one would be a chump for riding only with the bare minimum liability and DC/PD coverage; I'm thinking of adding additional coverage because medical **** is life-destroyingly expensive; I don't want to saddle my wife with a lifetime of diaper changes with a devastating bankruptcy cherry on top an already life-altering event cake.
 
Blackfin said:
Go look at your policy and see what costs what on it.

Looking at the renewal I just received for my Aprilia, I see a premium of $1293 for 19/20.

Of that:
- $51 is direct comp/property damage (3.9%)
- $239 is liability (18.5%)
- $144 is collision (11.1%)
- $54 is comprehensive (4.2%)

and

- $805 is statutory accident benefits (62.3%)

SABs constitute more than 62% of the cost of my premium. If the government hadn't mandated accident benefits I too could, in theory, be crowing about being able to ride covered only by direct-comp/prop and liability; in my case that would theoretically be $290 or twelve easy payments of $CAD24/mo for a 175HP, 1100cc hyper-naked.

You want to lower insurance costs? Lobby your local politician to make accident benefits optional and roll the dice by opting out. But you need to be ready to go it alone if something bad does happen.

I personally think one would be a chump for riding only with the bare minimum liability and DC/PD coverage; I'm thinking of adding additional coverage because medical **** is life-destroyingly expensive; I don't want to saddle my wife with a lifetime of diaper changes with a devastating bankruptcy cherry on top an already life-altering event cake.
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Thing is there would be a lot of folks that would opt out to save money. Those folks wouldn't be interesting to ambulance chasing lawyers if they had a very minor bump or bruise that could be converted to a $50,000 sore neck or back. As a result, the benefits would go to those who need and those who decide to pay.

Ya think the Lawyer Mafia and Fair would go for that?
 
Mad Mike said:
Thing is there would be a lot of folks that would opt out to save money. Those folks wouldn't be interesting to ambulance chasing lawyers if they had a very minor bump or bruise that could be converted to a $50,000 sore neck or back. As a result, the benefits would go to those who need and those who decide to pay.

Ya think the Lawyer Mafia and Fair would go for that?
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It's probably somewhat more complex than I suggest; fewer people paying SAB premiums would mean a smaller pool from which to pay benefits for those who opt in; that would likely need to be made up for with higher premiums for these benefits.

As well, people who opt out but are still critically injured in a collision are still going to be a burden on the health care and social welfare system. The burden will have shifted from the "private" sector (insurance) to some form of government care. I don't know; maybe they already are anyway.

And, as you note, powerful lobbies would stand to lose out in such a scenario so, yeah, probably a non-starter.

Anyway, my point was that if one is going to compare our rates to the insanely low rates seen in some parts of the US it would be helpful if that person would cross-compare all the benefits and coverages to ensure apples are indeed being compared to apples.
 
Blackfin said:
...Anyway, my point was that if one is going to compare our rates to the insanely low rates seen in some parts of the US it would be helpful if that person would cross-compare all the benefits and coverages to ensure apples are indeed being compared to apples.
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You won't get a 100% comparison, but you can get close. The big hurt in Canada is the fact the vehicle is required to carry AB -- not the driver -- that means you pay for the same insurance over and over again, folks with more stuff shoulder a much larger percentage of the insurance burden.

Lets say I have a Pickup and 2 motorcycles, lets compare Toronto and Tampa. Basic comparable coverage
Male, 55, married, clean record.
Toronto: Car $918/year. MC1 $966/yr MC2 $780 total $2664
Tampa (bundled price): $1466USD/$2000CAD

Apples to apples doesn't paint a perfect picture. In the US I can by blanket liability and accident benefits that cover me for everything - home, cars, motorcycles etc. In that case I'd pay about $20/mo for each vehicle. I can effectively get the same coverage for $975US or $1340CAD by purchasing al-la-carte. That's about half what I pay here.

Also remember I have great rates in Ontario, outside of the markup for where I live, my insurance profile is as good as it gets. Many would enjoy better savings than me. If I did the same on a 25 year old with the same toys, they would pay about $2500CAD in the Tampa vs $7400 in Ontario.
 
jemlinus said:
I have a friend living in California that has a 22year old nephew with R6. He pays $35 per month.
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Comparing cheap US insurance policies is apples and oranges to insurance in almost any province in Canada, Ontario included.

Those $35/month policy probably gives him about $100K in liability (if that) which will get sucked dry in a heartbeat in the guaranteed lawsuit if he actually ever injures someone else while riding, etc. Then he's on the hook for the potentially millions more. They often have laughable medical coverage as well on those cheap policies, which given the realities of the US medical system is probably going to be exhausted the second you roll into the ER, much less any additional days in the hospital afterwards. So again, you're hung out to dry at your own expense.

Millions of people go bankrupt and lose everything every year across the USA because of underinsurance whilst operating a motor vehicle.

We certainly pay a lot more here in Canada, but we DO get a lot more for it.

I'm not being an appologist for our agreeably broken (to some extent) system here, but when it comes to raw dollars and cents on what we are covered for, we are WAY better off.
 
I don't know what the coverage is. However, I like the fact that they have a choice. It will help the motorcycle industry and people with a tight budget.
 
PrivatePilot said:
Comparing cheap US insurance policies is apples and oranges to insurance in almost any province in Canada, Ontario included.

Those $35/month policy probably gives him about $100K in liability (if that) which will get sucked dry in a heartbeat in the guaranteed lawsuit if he actually ever injures someone else while riding, etc. Then he's on the hook for the potentially millions more. They often have laughable medical coverage as well on those cheap policies, which given the realities of the US medical system is probably going to be exhausted the second you roll into the ER, much less any additional days in the hospital afterwards. So again, you're hung out to dry at your own expense.

Millions of people go bankrupt and lose everything every year across the USA because of underinsurance whilst operating a motor vehicle.

We certainly pay a lot more here in Canada, but we DO get a lot more for it.

I'm not being an appologist for our agreeably broken (to some extent) system here, but when it comes to raw dollars and cents on what we are covered for, we are WAY better off.
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lol no. Millions? Try several thousand.

The reality is we pay thousands more for equivalent policies here. Most of it it the result of "accident benefits" and has little to do with the liability your describing.
There are less accidents in Canada. Less DUI, higher quality roads.
Even looking at MC insurance. The average rider here rides less per policy per year than in say, Florida.
The insurance industry is broken in this province. Mad Mike explains it pretty well. Way too many hands in the cookie jar, a government that doesnt care because it collects more money in taxation.

My mothers family lives in the UK.
My aunt pays $17 per month for her car insurance.
My uncle insures 3 bikes for a total of $340 a year.
When I told them I pay $3200 a year for 1 car and 1 bike with a perfect driving record, they thought I was joking.
 
PrivatePilot said:
Comparing cheap US insurance policies is apples and oranges to insurance in almost any province in Canada, Ontario included.

Those $35/month policy probably gives him about $100K in liability (if that) which will get sucked dry in a heartbeat in the guaranteed lawsuit if he actually ever injures someone else while riding, etc. Then he's on the hook for the potentially millions more. They often have laughable medical coverage as well on those cheap policies, which given the realities of the US medical system is probably going to be exhausted the second you roll into the ER, much less any additional days in the hospital afterwards. So again, you're hung out to dry at your own expense.

Millions of people go bankrupt and lose everything every year across the USA because of underinsurance whilst operating a motor vehicle.

We certainly pay a lot more here in Canada, but we DO get a lot more for it.

I'm not being an appologist for our agreeably broken (to some extent) system here, but when it comes to raw dollars and cents on what we are covered for, we are WAY better off.
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As I mentioned before, an apple to apples comparison is possible. If you buy the equivalent of what is mandatory in Ontario on a single vehicle, prices will be about the same. But you have lots of choices and you're not required to double pay - with a single dip restriction.

For example, I pay for an umbrella liability policy in FL, it covers me and my wife whether we're driving, boating, of cutting my lawn -- $2M, costs $350/year. I still need basic $100K liability on my auto policy, that costs $200/year on the first car, nothing on the next or my bikes.

Here in Ontario, my employers provides general accident benefit insurance as part of my benefit package. I have to purchase it 3 more times to cover my vehicles -- I have no way of opting out of something I'm already covered for.

The bottom line is there is very little choice when a market is controlled and regulated by a cartel. The user will always be squeezed for every penny. That's what we have today.

It's tough to change.
 
Mad Mike said:
As I mentioned before, an apple to apples comparison is possible. If you buy the equivalent of what is mandatory in Ontario on a single vehicle, prices will be about the same.
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Yes, but the point PP (and to some degree, myself) was making was that the 22yo in Cali paying $35/mo is likely not an apples to apples comparison. Without seeing the policy and coverage we can't say for sure but I bet PP is correct in that the coverage is a "bare minimum": If that kid needs an air-ambulance ride out of a canyon after a crash he (and his family) are probably screwed financially forever just for the cost of the helo, never mind the medical costs of his injuries.
 
Actually one correction to your post. Lawyers actually get NO percentage of funds in the settlement ear marked for REHAB treatments. they get their 30 - 40% of ANY funds, (also excluding what the insurer pays you for damage, or writing your vehicle off). The lawyers get their cut of anything the insurer doesn't list as being "medical rehab"

Trust me the insurers, try to ear mark as little as they can for medical rehab, (otherwise, the "victim" would after disbursements, and the "cut" is taken out, end up with virtually nothing). one of my AB claims was settled over a year ago. The "settlement" was for $20,500, I ended up receiving approx $6,000 of that. rest went to paying lawyers, and their "experts" that I had to go see to get an examination to counter the insurer's doctors, "opinions"...hmmmm I mean examination, which some how miraculously always seems to find your better than you were pre claim... EVERY time.

Also, remember, that if call that firm, whose name indicates they are a precious gem. That firm almost NEVER actually handles your claim, they instead "refer" your file to another firm. You then agree to them getting a 40% retainer of the settlement. Small firm, (who does all the work), gets 32.5 - 35% of the settlement, while the other 5% - 7.5% goes to the precious gem firm, (to compensate them for the referral).

Mad Mike said:
Here's what's in it for each stakeholder:

Lawyers. Chasing ambulances is lucrative. Since these guys get paid a percentage of the settlement, it's in their best interest to drive up the costs throught medical referrals, rehab etc.

Rehab industry collaborates with ambulance chasers. They even have a lobby group, FAIR, disguised as a victims right's advocate. Read more at Corporate Members that Support FAIR - FAIR. Without lawyers, these folks claim victims would be at the mercy of OHIP. Instead they get a steady stream of lucrative referrals from Lawyers!

Towing, Tips for Avoiding Tow Truck and Storage Scams

Body Shops.

Insurance companies: Unlike any other industry, they are able to build fraud into their cost with impunity. They have no incentive fight fraud as long as the FSCO allows them include it as a cost of business.

Govt. Just think -- the gov't collects HST off ever fraud dollar billed. They also take OHIP compensation payouts from the insurance companies that are reentered as cost which again are passed along to consumers.
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hedo2002 said:
Actually one correction to your post. Lawyers actually get NO percentage of funds in the settlement ear marked for REHAB treatments. they get their 30 - 40% of ANY funds, (also excluding what the insurer pays you for damage, or writing your vehicle off). The lawyers get their cut of anything the insurer doesn't list as being "medical rehab"

Trust me the insurers, try to ear mark as little as they can for medical rehab, (otherwise, the "victim" would after disbursements, and the "cut" is taken out, end up with virtually nothing). one of my AB claims was settled over a year ago. The "settlement" was for $20,500, I ended up receiving approx $6,000 of that. rest went to paying lawyers, and their "experts" that I had to go see to get an examination to counter the insurer's doctors, "opinions"...hmmmm I mean examination, which some how miraculously always seems to find your better than you were pre claim... EVERY time.

Also, remember, that if call that firm, whose name indicates they are a precious gem. That firm almost NEVER actually handles your claim, they instead "refer" your file to another firm. You then agree to them getting a 40% retainer of the settlement. Small firm, (who does all the work), gets 32.5 - 35% of the settlement, while the other 5% - 7.5% goes to the precious gem firm, (to compensate them for the referral).
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So you don't think the lawyer's experts provide any type of referral fee back to the lawyers?

At the end of the day the insurer paid out $20,500 for you to get $6K. Any chance you insurance rates went up?
 
Blackfin said:
Yes, but the point PP (and to some degree, myself) was making was that the 22yo in Cali paying $35/mo is likely not an apples to apples comparison. Without seeing the policy and coverage we can't say for sure but I bet PP is correct in that the coverage is a "bare minimum": If that kid needs an air-ambulance ride out of a canyon after a crash he (and his family) are probably screwed financially forever just for the cost of the helo, never mind the medical costs of his injuries.
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You may be right. Unless that fellow already purchased AB with his car, or gets AB as a benefit from his employer. When I lived in California my employer offered AB in my benefits package (as does my Canadian employer) so I didn't need to buy that -- my car insurance was $28/mo. Here in Canada I pay for it 3 times: on my car, truck, and motorcycle even though I already have adequate coverage from my employer.
 
Blackfin said:
Yes, but the point PP (and to some degree, myself) was making was that the 22yo in Cali paying $35/mo is likely not an apples to apples comparison. Without seeing the policy and coverage we can't say for sure but I bet PP is correct in that the coverage is a "bare minimum": If that kid needs an air-ambulance ride out of a canyon after a crash he (and his family) are probably screwed financially forever just for the cost of the helo, never mind the medical costs of his injuries.
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Let me know if anybody can get coverage for a 22year old with R6.
 
Ahem - at the risk of getting back on topic, no matter what your premium is the first $250 of it is earmarked to pay out on fraudulent claims.
What's wrong with this picture ? People go to jail for this kind of activity.
 
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